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February 16, 2016

Lebanon’s drug users | Executive Magazine

Not much is known about Captagon prevalence in Lebanon. Anecdotal testimony regarding court cases and rehabilitation treatments suggest that use is low but rising. The prevailing explanation for this is that there is a leakage of pills into the drug-using community as more Captagon is produced in the country and trafficked through it, but there are no statistics to verify the extent. What is known is that individuals caught using the drug are arrested and that there is deficient data on the number of Captagon-specific criminal proceedings.

“Drugs have spread so much in the last few years,” says Faisal Abdallah, a Lebanese lawyer specialized in criminal law. Executive was not able to obtain statistics on drug-related criminal proceedings, neither in general nor specific to Captagon – the Ministry of Justice did not respond to Executive’s request and Mohammed Saab, a judge who has presided over user-related hearings, declined an interview to discuss the findings of a book he published on drug-related crimes in 2015. Whether user-related arrest figures have risen as a function of drug prevalence or due to vigilant law enforcement cannot be answered.

According to statistics from the Internal Security Forces’ (ISF) drug unit obtained by The Legal Agenda – a non-governmental organization monitoring Lebanon’s judicial system – 5,381 individuals were prosecuted for Captagon use in 2013 and 2014, about 2,000 more than in 2009 and 2010. But the failure to report details of the number of users arrested and prosecuted for popping pills, alongside a complete dearth of data on Captagon rehabilitation, results in an inability to define the problem. Rather, what the figures show is that Lebanon’s police are increasingly arresting, prosecuting and jailing drug users when the law says rehabilitation should be an alternative.

Even first-time offenders face serious and punitive consequences rather than the rehabilitation they should be offered. Depending on the drug, a first-time offender can face fines of 2 million to 5 million Lebanese Lira ($1,327 – $3,318) and prison time ranging between three months to three years. Arrested drug users are, according to the law, entitled to be heard by a committee set up in 2013 to follow up on rehabilitation treatment. The Legal Agenda found that the committee is hardly used, hearing only 120 cases in 2013 and 2014.

A clogged up system

The Legal Agenda, Abdallah and addictions psychiatrist Joseph Khoury all agree that underutilization of the committee has two causes. Its ad hoc nature – the committee’s board members are volunteers and it has no clear mandate – undermines its purpose because the government, the police and the legal profession do not take it seriously. But the greater challenge is due to a backed-up judicial system, Abdallah says. Offenders can only be referred to the committee once a judge has heard their case, but because the court system is so clogged, offenders rarely receive their right to present their case to the committee for treatment referral. Instead, drug offenders face prison time, incurring a criminal record, and are thrown into the general prison population. This, the Legal Agenda says, means that users are subject to upfront punishment that deters them from seeking drug rehabilitation treatment on their own.

Lebanon’s narcotics law 673/1998 classifies drug use as a health issue but in practice the judicial system still views it as a crime, and offenders have many obstacles in their way to receive rehabilitation treatment. A drug user has to be very motivated, Khoury says, because they may have to pay out of pocket – government insurance programs cover psychiatric care and drug addiction treatment for security forces and public sector workers, and private insurers cover some segments of the population, but this leaves many insufficiently covered. Lebanon’s Ministry of Public Health does not have enough money to cover those that fall between the cracks.

A 2010 report from the World Health Organization (WHO) pointed out that some of Lebanon’s public health budget was allocated for mental health services, but that it included neither short-term inpatient care nor outpatient care and only covered certain psychotropic medicines. WHO called for the establishment of in- and out-patient treatment centers for substance abuse, but acknowledged a lack of funding to do so as well as a lack of specialists – psychiatrists and psychiatric nurses – to staff those facilities. Khoury told Executive much the same in a January interview – that Lebanon does not have enough psychiatrists nor the health infrastructure to rehabilitate users.

The recommendation of The Legal Agenda is to empower the committee to enable the treatment alternative to imprisonment. But this, the NGO says, would at least require the expansion of the committee’s mandate, and adding a committee in each of Lebanon’s six governorates to hear rehabilitation cases of offenders in different parts of the country. This, however, would require amendment to the law to both articulate and expand the committee’s mandate, as well as to fund it and a healthcare rehabilitation system to treat users. “I would be for not incarcerating any users – I think people need to be treated,” prescribes Khoury.

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